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Decreased Mortality After Long-Term Treatment With Dipeptidyl Peptidase-4 Inhibitors: A Retrospective Study of U.S. Veterans With Type 2 Diabetes
- Source :
- Endocrine Practice. 28:8-15
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- OBJECTIVE The prevalence of chronic kidney disease (CKD) in the United States is 13% of the general population. Among those with CKD, diabetic nephropathy is the leading cause of end-stage renal disease. This is a retrospective study examining the effect of long-term use of dipeptidyl peptidase-4 (DPP-4) inhibitors on all-cause mortality and progression of renal disease in the veteran population. METHODS Data was extracted using the Veterans Administration Informatics and Computing Infrastructure. A large cohort of veterans diagnosed with type 2 diabetes mellitus were used to identify patients on DPP-4 inhibitors and without DPP-4 inhibitors. Groups were compared to determine the effect of DPP-4 inhibitors on the progression of CKD and all-cause mortality. Data were analyzed using SAS. RESULTS Subjects in the treatment group (n = 40 558) had baseline variables (age, body mass index, race) similar to the control group (n = 40 558). Diabetes control improved in the treatment group (HgbA1c, 8.3% [67 mmol/mol] to 7.8% [62 mmol/mol]; P < .001) but not in the control group (HgbA1c, 7.4% [57 mmol/mol] to 7.3% [56 mmol/mol]). New diagnoses of heart failure and coronary artery bypass grafts were clinically significant (odds ratios = 0.66 and 0.52). No change in progression of CKD was seen in either group. All-cause mortality was reduced by 59%. CONCLUSION We conclude that DPP-4 inhibitors are associated with a significant reduction in all-cause mortality independent of glucose control, albeit with no clear cause, including obtainable cardiovascular outcomes. Our data is consistent with prior trials in that DPP-4 inhibitors did not show a significant change in serum creatinine or microalbuminuria.
- Subjects :
- Male
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
Population
Renal function
Type 2 diabetes
End stage renal disease
Endocrinology
Internal medicine
medicine
Humans
Hypoglycemic Agents
Renal Insufficiency, Chronic
education
Aged
Retrospective Studies
Veterans
Dipeptidyl-Peptidase IV Inhibitors
education.field_of_study
business.industry
Type 2 Diabetes Mellitus
Odds ratio
Middle Aged
medicine.disease
United States
Diabetes Mellitus, Type 2
Female
Microalbuminuria
business
Kidney disease
Subjects
Details
- ISSN :
- 1530891X
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Endocrine Practice
- Accession number :
- edsair.doi.dedup.....d02be818e74a6aab68f144e721d34e65